A coronary angiography is a test to find out if you have a blockage in a coronary artery. Your doctor will be concerned that you are at risk of a heart attack if you have unstable angina, atypical chest pain, aortic stenosis, or unexplained heart failure.
During the coronary angiography, a contrast dye will be injected into the arteries through a catheter (thin, plastic tube), while a doctor watches how blood flows through your heart on an X-ray screen.
This test is also known as a cardiac angiogram, catheter arteriography, or cardiac catheterization.
Doctors will often use magnetic resonance imaging (MRI) or a computerized tomography (CT) scan before a coronary angiography test, in an effort to pinpoint problems with your heart.
Do not eat or drink anything for eight hours before the angiography. Arrange for someone to give you a ride home, and to stay with you the night after your test, because you may feel dizzy or light-headed for the first 24 hours after the cardiac angiography.
In many cases, you will be asked to check into the hospital the morning of the test, and you will be able to check out later the same day.
At the hospital, you will be asked to wear a hospital gown and to sign consent forms. The nurses will take your blood pressure, start an intravenous line (IV), and, if you have diabetes, check your blood sugar. You may also have to undergo a blood test and an electrocardiogram (ECG).
Let your doctor know if you are allergic to seafood, if you have had a bad reaction to contrast dye in the past, if you are taking sildenafil (Viagra), or if you might be pregnant.
Before the test, you will be given a mild sedative to help you relax. You will be awake throughout the test.
Your doctor will clean and numb an area of your body in the groin or arm with an anesthetic. You may feel a dull pressure as a sheath opens an artery for a thin tube called a catheter. The catheter will gently be guided up to an artery in your heart. The doctor will supervise the whole process on a screen.
It is unlikely that you will feel the tube move through your blood vessels.
A slight burning or “flushing” sensation can be felt after the dye is injected.
After the test, pressure will be applied at the site where the catheter is removed to prevent bleeding. If the catheter is placed in your groin, you may be asked to lie flat on your back for a few hours after the test to prevent bleeding. This can cause mild back discomfort.
Drink plenty of water after the test to help your kidneys flush out the contrast dye.
A desired result is that there is a normal supply of blood to your heart and no blockages. An abnormal result may mean that you have one or more blocked arteries. If you have a blocked artery, your doctor may choose to do an angioplasty to immediately improve blood flow.
Cardiac catheterization is very safe when performed by an experienced team, but there are risks.
Risks can include:
- bleeding or bruising
- blood clots
- injury to the artery or vein
- a small risk of stroke
- a very small chance of a heart attack or a need for bypass surgery
- low blood pressure
It used to be thought that a cardiac angiography could injure a kidney, but research published in the European Heart Journal early in 2012 showed that this was a rare complication (Ko, et al., 2012).
Relax and drink plenty of water. Do not smoke or drink alcohol. Remember you have had an anesthetic so don’t drive, operate machinery, or make any important decisions.
Remove the bandage after 24 hours. If there is minor oozing, apply a fresh bandage for another 12 hours.
For two days, do not have sex or perform any heavy exercise.
Do not take a bath, use a hot tub, or use a pool for at least three days. You may shower. Do not apply lotion near the puncture site for three days. You will need to see your heart doctor a week after the test.